OBJECTIVE To determine the outcome and side effects of a new drug protocol to induce abortion. METHODS Case series. METHODS An urban primary care practice. METHODS One hundred consecutive patients who requested elective termination of pregnancies of less than 8 weeks' gestation. METHODS Subjects received methotrexate (50 mg/m2 body surface area, administered intramuscularly) and, 3 days afterward, misoprostol (800 micrograms, given vaginally). METHODS Number of abortions induced within 24 hours and within 10 days of misoprostol administration, number of surgical aspirations conducted because of incomplete abortion, mean amount of bleeding and pain and the number of women who, if faced with the same situation, said they would again choose a drug-induced abortion over a surgical one. RESULTS Abortion occurred within 24 hours of misoprostol administration among 48 women and within 10 days among 69 women. In total, 89 women had an abortion without surgical aspiration. Of these women, 71 said they would choose a drug-induced abortion if faced with the choice again. CONCLUSIONS Abortion induced with methotrexate and misoprostol appears to be a feasible alternative to surgical abortion and deserves further study.